| NPI | 1902102858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: UT 6000064-6009) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: UT 6000064-6006) |
| Enumeration Date | 2011-02-09 |
| Last Update Date | 2014-07-02 |