| NPI | 1932494200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TN 000000547) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: TN 0000002263) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2011-06-15 |