| NPI | 1881920213 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MO 2009012867) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: 8745) |
| Enumeration Date | 2009-10-20 |
| Last Update Date | 2019-11-15 |