| NPI | 1851803043 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD SC1230) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: 508458) |
| 101YP2500X Counselor, Professional (Licence: DC PRC95) | |
| Enumeration Date | 2017-10-29 |
| Last Update Date | 2017-10-29 |