NPI | 1225602311 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LSAT-15151) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ 3088) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 20104) | |
Enumeration Date | 2021-05-13 |
Last Update Date | 2021-05-13 |