| NPI | 1255348504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ND 1269) |
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator (Licence: ND 000079154) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2007-07-08 |