| NPI | 1114346053 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA t20052) | 
| Additional Taxonomies | 101Y00000X Counselor | 
| Enumeration Date | 2014-04-08 | 
| Last Update Date | 2021-06-02 |