| NPI | 1972753473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK 1166) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OK 2630) |
| Enumeration Date | 2008-09-22 |
| Last Update Date | 2015-09-04 |