| NPI | 1194297564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 30991) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: 3) |
| Enumeration Date | 2018-12-26 |
| Last Update Date | 2018-12-26 |