| NPI | 1871746479 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AK 3411) |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2013-02-04 |