| NPI | 1285616656 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 1005) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 3653-125) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2007-07-08 |