| NPI | 1124465216 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 6233) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IL 36-2709982) |
| 101YP2500X Counselor, Professional (Licence: WI 6233) | |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2020-06-09 |