| NPI | 1083947519 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: 1543) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC provisional) |
| 225C00000X Rehabilitation Counselor (Licence: NC 00100749) | |
| Enumeration Date | 2009-09-16 |
| Last Update Date | 2015-03-02 |