| NPI | 1003230244 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: PA PC010357) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: PA PC010357) |
| 163W00000X Registered Nurse (Licence: PA RN564935) | |
| 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: PA RN564935) | |
| Enumeration Date | 2014-02-07 |
| Last Update Date | 2018-12-11 |