| NPI | 1235537630 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 11295) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 20737) |
| Enumeration Date | 2014-12-17 |
| Last Update Date | 2021-07-16 |