| NPI | 1003453168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR T-20-355) |
| Additional Taxonomies | 247000000X Technician, Health Information |
| Enumeration Date | 2019-12-06 |
| Last Update Date | 2022-03-15 |