| NPI | 1124462031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AL 2458) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: AL 223809) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AL 019) | |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2013-04-22 |