| NPI | 1063634020 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CT 1299) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CT 0012299) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CT 608) | |
| 163W00000X Registered Nurse (Licence: CT 66799) | |
| Enumeration Date | 2007-05-02 |
| Last Update Date | 2014-08-21 |