| NPI | 1144755752 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: GA RN313166) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA 954) |
| Enumeration Date | 2017-04-21 |
| Last Update Date | 2023-02-02 |