| NPI | 1306297742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6802088913) |
| Additional Taxonomies | 247200000X |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2017-02-06 |