| NPI | 1023078482 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 3363) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 5874) |
| Enumeration Date | 2006-03-27 |
| Last Update Date | 2009-06-24 |