| NPI | 1336578384 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CT 3193) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 1044) |
| Enumeration Date | 2013-11-09 |
| Last Update Date | 2024-03-12 |