| NPI | 1932638640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 0000856) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO 0104375) |
| 101YP2500X Counselor, Professional (Licence: CO 0014545) | |
| Enumeration Date | 2017-06-06 |
| Last Update Date | 2018-03-17 |