| NPI | 1902173875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO MFTC.0013460) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 7491) |
| Enumeration Date | 2011-11-21 |
| Last Update Date | 2015-06-16 |