| NPI | 1891058046 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401011597) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: MI 820317) |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2021-11-10 |