| NPI | 1124151022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 19541) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MA 4024247) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2021-04-09 |