| NPI | 1104065150 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15343-131) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 4153-125) |
| Enumeration Date | 2009-02-16 |
| Last Update Date | 2009-02-16 |