| NPI | 1003200692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 5992-125) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 17387-130) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16144-131) | |
| 101YP2500X Counselor, Professional (Licence: WI 1345-266) | |
| Enumeration Date | 2015-03-23 |
| Last Update Date | 2022-07-21 |