| NPI | 1063667616 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 6703) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD0000595) |
| 101YP2500X Counselor, Professional (Licence: CO 5076) | |
| 101YP2500X Counselor, Professional (Licence: CO LPC0005076) | |
| Enumeration Date | 2008-11-24 |
| Last Update Date | 2021-02-05 |