| NPI | 1134109416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6301002591) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6301002591) |
| 101YP2500X Counselor, Professional (Licence: 6401003945) | |
| Enumeration Date | 2006-01-20 |
| Last Update Date | 2007-07-08 |