| NPI | 1063728426 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: LA 5559) |
| Additional Taxonomies | 183500000X Pharmacist (Licence: LA 018080) |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2023-04-14 |