| NPI | 1033298682 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 22683) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: PA 000906) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA 4010) | |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2010-04-05 |