| NPI | 1922046499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CO 4694) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CO 2043) |
| 101YP2500X Counselor Professional (Licence: CO 2043) | |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2007-07-09 |