| NPI | 1104253293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NV 00978) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: 710216) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: A7590312) | |
| Enumeration Date | 2013-10-03 |
| Last Update Date | 2013-10-03 |