| NPI | 1205980802 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: CO LPC-6372) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO CAC III-6861) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2012-09-27 |