| NPI | 1104164235 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC00180700) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: PA PC009315) |
| Enumeration Date | 2013-01-24 |
| Last Update Date | 2018-03-29 |