| NPI | 1013202753 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: SC 4277) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: SC 1105273) |
| 101YP2500X Counselor Professional (Licence: NC 4317) | |
| Enumeration Date | 2011-06-10 |
| Last Update Date | 2011-06-10 |