| NPI | 1134314503 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: OK 4671) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OK 810) |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2011-10-25 |