| NPI | 1164844114 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: CO 3964) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 6284) |
| 163W00000X Registered Nurse (Licence: CO 87944) | |
| Enumeration Date | 2014-01-10 |
| Last Update Date | 2014-01-10 |