| NPI | 1891179909 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AL 572508122010) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA G0108) |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2020-08-05 |