| NPI | 1073901807 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 0012535) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 178.009199) |
| Enumeration Date | 2015-01-01 |
| Last Update Date | 2017-08-01 |