| NPI | 1134591720 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA C041309317) |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2020-11-09 |