| NPI | 1164692455 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 05-11-34) | 
| Enumeration Date | 2008-03-03 | 
| Last Update Date | 2019-07-10 |