NPI | 1124193362 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 4827) |
Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: NY 131862) |
Enumeration Date | 2006-11-22 |
Last Update Date | 2007-07-08 |