| NPI | 1265097844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA CIT-5785) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA RN142573) |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2024-04-24 |