| NPI | 1235416215 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 2062) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 10900) |
| 101YP2500X Counselor, Professional (Licence: KY 168173) | |
| Enumeration Date | 2011-11-04 |
| Last Update Date | 2016-06-30 |