| NPI | 1285687483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 12563) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: WI 6640-123) |
| 163WP0808X Registered Nurse Psychiatric/Mental Health (Licence: WI 81985-030) | |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2007-07-08 |