| NPI | 1023137361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: VA 0701002813) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: VA 0718000075) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2013-06-27 |