| NPI | 1235398744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 8371) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 1808) |
| Enumeration Date | 2008-06-09 |
| Last Update Date | 2012-07-03 |