NPI | 1063881621 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: ND 780-3-15-14-263) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ND 1754) |
Enumeration Date | 2015-09-24 |
Last Update Date | 2020-01-03 |