NPI | 1124002977 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 000132) |
Additional Taxonomies | 163W00000X Registered Nurse (Licence: CT E47103) |
Enumeration Date | 2005-12-05 |
Last Update Date | 2007-07-08 |