| NPI | 1043334790 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CT 001624) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MI 6401008004) |
| Enumeration Date | 2007-03-19 |
| Last Update Date | 2011-08-05 |