| NPI | 1275877250 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C4730) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR CGACI: G13-04-06) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR CADCI: 14-05-07) | |
| Enumeration Date | 2012-11-15 |
| Last Update Date | 2018-06-29 |