| NPI | 1154606317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 15830-132) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: WI 5114-125) |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2014-02-11 |