| NPI | 1134129554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WY 266) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WY 727) |
| Enumeration Date | 2005-07-28 |
| Last Update Date | 2017-03-10 |