| NPI | 1912049719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT 1000) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MT 1000) |
| 101YM0800X Counselor, Mental Health (Licence: UT 332925-6004) | |
| Enumeration Date | 2007-02-12 |
| Last Update Date | 2007-07-09 |