| NPI | 1205251345 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 12013) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 180.007718) |
| Enumeration Date | 2014-02-26 |
| Last Update Date | 2014-02-26 |