| NPI | 1114953288 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: SC 3800) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: SC 637) |
| Enumeration Date | 2006-06-23 |
| Last Update Date | 2019-07-23 |