| NPI | 1902922321 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MD LC4290) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 25413) |
| 101YP2500X Counselor, Professional (Licence: IL 178.004708) | |
| Enumeration Date | 2007-03-21 |
| Last Update Date | 2016-04-04 |