| NPI | 1326438847 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO CACIII 2381) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CO LPC 4101) |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2015-02-04 |