| NPI | 1285116038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: VA 0701007838) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 1226) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0718000243) | |
| Enumeration Date | 2018-08-29 |
| Last Update Date | 2018-08-29 |