| NPI | 1922424092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-21878) |
| Additional Taxonomies | 251S00000X (Licence: NC LCAS-21878) |
| Enumeration Date | 2014-03-12 |
| Last Update Date | 2017-05-10 |