| NPI | 1295032134 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15680-321) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 347-226) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15656-130) | |
| Enumeration Date | 2011-02-11 |
| Last Update Date | 2014-09-17 |