| NPI | 1235417890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CO 11695) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO acb-7403) |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2021-11-30 |