| NPI | 1205379567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS LCAC 606) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS T-LMAC 211) |
| Enumeration Date | 2016-11-18 |
| Last Update Date | 2017-02-08 |