| NPI | 1902111313 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 10-r-25) |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2015-12-15 |