| NPI | 1063531440 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: MO 2007025784) |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: MO 062430) |
| Enumeration Date | 2007-03-28 |
| Last Update Date | 2008-05-05 |