| NPI | 1164464277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC-10963) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: AZ LPC-11732) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 07-R-16) | |
| 101YP2500X Counselor, Professional (Licence: OR LPC) | |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2008-06-30 |