| NPI | 1942615307 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NJ 37pc00497800) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37lc00212300) | 
| Enumeration Date | 2014-06-24 | 
| Last Update Date | 2016-01-29 |