| NPI | 1205267994 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 16649) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16649-130) |
| 101Y00000X Counselor (Licence: WI 1967-226) | |
| Enumeration Date | 2013-12-05 |
| Last Update Date | 2024-02-06 |