| NPI | 1255680898 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT 1359) |
| Additional Taxonomies | 101YS0200X Counselor, School (Licence: MT 83094) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2012-08-29 |