| NPI | 1306141932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: OR C4106) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 11-06-69) |
| Enumeration Date | 2011-01-12 |
| Last Update Date | 2016-04-06 |