| NPI | 1861645020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OK 2718) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OK 0141) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK 333) | |
| Enumeration Date | 2008-10-31 |
| Last Update Date | 2008-10-31 |