| NPI | 1205213766 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16208) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 15883) |
| Enumeration Date | 2015-05-04 |
| Last Update Date | 2023-05-26 |