| NPI | 1922049345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 373) |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist (Licence: WI 506) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2007-07-08 |