| NPI | 1225528607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: IA 091068) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 18013) |
| Enumeration Date | 2018-05-11 |
| Last Update Date | 2020-10-05 |