| NPI | 1174838866 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 2085) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 75422) |
| 101YP2500X Counselor, Professional (Licence: NC A9166) | |
| Enumeration Date | 2010-08-18 |
| Last Update Date | 2012-11-30 |