| NPI | 1063652063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MN 303033) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WA RC60049463) |
| Enumeration Date | 2009-03-03 |
| Last Update Date | 2011-08-08 |