| NPI | 1922117621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO 560) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 4607) |
| 101YM0800X Counselor, Mental Health (Licence: IL 149-000804) | |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2007-11-18 |