| NPI | 1134490998 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 000941) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CT 002075) |
| Enumeration Date | 2012-01-25 |
| Last Update Date | 2013-08-29 |