| NPI | 1992043772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 11450-132) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 5314-120) |
| Enumeration Date | 2013-01-29 |
| Last Update Date | 2013-01-29 |