| NPI | 1033543731 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: CA VN230370) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 167G00000X Licensed Psychiatric Technician (Licence: CA VN203070) | |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2013-08-29 |