| NPI | 1174991657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: AL 3656) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AL AADC-049) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AL 510276) | |
| Enumeration Date | 2015-09-14 |
| Last Update Date | 2017-02-10 |