| NPI | 1073729356 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: IL 0079236) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 19875) |
| 101YM0800X Counselor, Mental Health (Licence: NY 003817) | |
| Enumeration Date | 2007-05-15 |
| Last Update Date | 2007-07-08 |