| NPI | 1134419344 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 4905) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: GA 007585) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 508050) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SC 1307264) | |
| 101YP2500X Counselor, Professional (Licence: NC 11681) | |
| Enumeration Date | 2011-04-10 |
| Last Update Date | 2016-09-06 |