| NPI | 1922403682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM 0168651) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NM 00118411) |
| 101YM0800X Counselor, Mental Health (Licence: NM 0169331) | |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2014-10-23 |