| NPI | 1972933620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 14612) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 2928-A) |
| Enumeration Date | 2013-11-16 |
| Last Update Date | 2021-02-09 |