| NPI | 1245312974 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.006727) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 25633) |
| 101YP2500X Counselor, Professional (Licence: IL 178004375) | |
| Enumeration Date | 2006-10-20 |
| Last Update Date | 2024-05-12 |