| NPI | 1194828749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: RI 00019) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: RI 1SW00439) |
| 101YM0800X Counselor, Mental Health (Licence: MA 107784) | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2007-07-08 |