| NPI | 1134187750 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 13209) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NA) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2008-05-22 |