| NPI | 1164724415 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 1581) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC 00111147) |
| 101YP2500X Counselor, Professional (Licence: NC A8786) | |
| Enumeration Date | 2010-11-18 |
| Last Update Date | 2012-06-13 |