| NPI | 1144686593 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 22505) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2016-01-14 |
| Last Update Date | 2017-03-15 |