| NPI | 1871632281 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: SC 4607) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: SC 4607) |
| 101YM0800X Counselor Mental Health (Licence: SC 4607) | |
| Enumeration Date | 2007-02-05 |
| Last Update Date | 2010-05-12 |