| NPI | 1124174024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC016231) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6401009820) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 10138) | |
| 101YP2500X Counselor, Professional (Licence: MI 6401009820) | |
| 101YP2500X Counselor, Professional (Licence: NC 10138) | |
| Enumeration Date | 2007-01-25 |
| Last Update Date | 2023-10-24 |