| NPI | 1942471701 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.006701) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 26399) | 
| Enumeration Date | 2008-03-19 | 
| Last Update Date | 2012-04-06 |