| NPI | 1205185238 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 2599) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC A9460) |
| Enumeration Date | 2012-09-06 |
| Last Update Date | 2016-03-01 |