| NPI | 1003972894 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 02-07-56) | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: OR 56141) | 
| Enumeration Date | 2006-12-28 | 
| Last Update Date | 2012-12-18 |