| NPI | 1174987127 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: CA 257759) |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2016-12-21 |