| NPI | 1952716292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: FL MH 12569) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: FL 4233) |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2014-06-25 |