| NPI | 1225525777 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA MSW007898) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: GA MSW007898) |
| Enumeration Date | 2018-04-20 |
| Last Update Date | 2018-09-06 |