| NPI | 1972968311 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 178011518) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 178.011518) |
| Enumeration Date | 2015-12-30 |
| Last Update Date | 2018-05-04 |