| NPI | 1902113285 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 000499) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: VT 000499) |
| Enumeration Date | 2010-09-08 |
| Last Update Date | 2012-02-03 |