NPI | 1326583782 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA 14585-RAC) |
Additional Taxonomies | 164X00000X Licensed Vocational Nurse (Licence: CA 259880) |
Enumeration Date | 2016-12-21 |
Last Update Date | 2021-03-18 |