| NPI | 1043649700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: LA 5319) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: LA 1463) |
| Enumeration Date | 2013-11-04 |
| Last Update Date | 2018-07-02 |