| NPI | 1962612796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NE 3070) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE P-591) |
| 101YP2500X Counselor, Professional (Licence: NE 1592) | |
| Enumeration Date | 2007-05-23 |
| Last Update Date | 2008-05-29 |