| NPI | 1023316874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ND 1320) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: ND 348-3-1-96-108) |
| Enumeration Date | 2011-03-03 |
| Last Update Date | 2011-03-03 |