| NPI | 1134570948 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OR 97-04-52) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OR G 00-00-12) |
| 101Y00000X Counselor (Licence: OR 835) | |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2016-06-23 |