| NPI | 1285644625 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WI 3488) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 3488-125) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2009-05-29 |