| NPI | 1134486475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NM 4272) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2012-08-21 |