| NPI | 1972785756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NM 0143771) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VT 068-75737) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM 0143781) | |
| Enumeration Date | 2007-12-03 |
| Last Update Date | 2014-04-01 |