| NPI | 1134239973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 0645AL) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MA 026715) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2015-12-02 |