| NPI | 1033514807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MD LC5859) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD LCA2422) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC00204000) | |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2018-03-17 |