| NPI | 1285705459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 4500) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 1050) |
| 101YP2500X Counselor, Professional (Licence: SC 6530) | |
| Enumeration Date | 2006-11-10 |
| Last Update Date | 2018-08-09 |