| NPI | 1962833871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MI 6401011040) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6401011040) |
| 101YM0800X Counselor, Mental Health (Licence: MI 6401011040) | |
| Enumeration Date | 2013-12-02 |
| Last Update Date | 2013-12-02 |