| NPI | 1861696122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NE 286) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NE 136) |
| 101YP2500X Counselor Professional (Licence: NE 491) | |
| 106H00000X Marriage & Family Therapist (Licence: NE 066) | |
| Enumeration Date | 2007-06-12 |
| Last Update Date | 2007-07-08 |