| NPI | 1043415854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NM 0122361) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM 0122361) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ 11440) | |
| Enumeration Date | 2007-06-20 |
| Last Update Date | 2018-06-28 |