| NPI | 1134510852 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ND 1749) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: ND L10294) |
| Enumeration Date | 2015-02-17 |
| Last Update Date | 2017-11-14 |