| NPI | 1013427988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 151-0134075) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: VT 097-0132617) |
| Enumeration Date | 2017-10-05 |
| Last Update Date | 2019-06-19 |