| NPI | 1063803575 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL MCAP.0101036) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: FL PN5206429) |
| Enumeration Date | 2015-02-05 |
| Last Update Date | 2025-05-28 |