| NPI | 1265796775 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: VA 0701005265) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0710102689) |
| Enumeration Date | 2012-06-28 |
| Last Update Date | 2013-02-09 |