| NPI | 1295016095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 7674) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC S7674) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 3130) | |
| Enumeration Date | 2011-09-07 |
| Last Update Date | 2020-06-18 |