| NPI | 1053529636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM 3955) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ 1864) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ 17315) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ RRNN32) | |
| Enumeration Date | 2007-05-18 |
| Last Update Date | 2019-09-20 |