| NPI | 1982934238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: GA LPC005849) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA LPC005849) |
| Enumeration Date | 2010-01-09 |
| Last Update Date | 2012-09-18 |