| NPI | 1972527000 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: GA 001262) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: GA 001262) |
| Enumeration Date | 2006-07-26 |
| Last Update Date | 2014-01-17 |