| NPI | 1104113323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NE 266) |
| Additional Taxonomies | 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: NE 72568) |
| Enumeration Date | 2011-07-08 |
| Last Update Date | 2023-06-02 |