| NPI | 1871660431 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 103483) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 000310) |
| 101YM0800X Counselor, Mental Health (Licence: MA 4639) | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2007-07-08 |