| NPI | 1073710216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0001734) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: CO PN.0049147) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2022-09-02 |