| NPI | 1073873535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180008189) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC 231141) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 28375) | |
| Enumeration Date | 2012-05-18 |
| Last Update Date | 2012-05-18 |