| NPI | 1063955029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC00312000) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: PA PCB Cert #9421) |
| Enumeration Date | 2016-11-23 |
| Last Update Date | 2020-02-12 |