| NPI | 1003032582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 906) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 110571) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2007-07-08 |