| NPI | 1235595968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OR 10-12-67) |
| Additional Taxonomies | 101Y00000X Counselor |
| Enumeration Date | 2016-01-11 |
| Last Update Date | 2016-04-22 |