| NPI | 1194908673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: WI 973-123) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 1911-132) |
| 163W00000X Registered Nurse (Licence: WI 41435-030) | |
| Enumeration Date | 2007-12-07 |
| Last Update Date | 2007-12-07 |