| NPI | 1982777900 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 865) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 399) |
| 101YM0800X Counselor, Mental Health (Licence: NC 7884) | |
| 101YP2500X Counselor, Professional (Licence: NC 7884) | |
| Enumeration Date | 2006-11-16 |
| Last Update Date | 2015-12-11 |