NPI | 1962986653 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 101Y00000X Counselor (Licence: IL 178012140) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 35207) |
Enumeration Date | 2018-09-19 |
Last Update Date | 2018-10-02 |