| NPI | 1194277301 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MI 2-01431) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: AZ LASAC-15112) |
| Enumeration Date | 2016-11-04 |
| Last Update Date | 2016-11-04 |