| NPI | 1346583804 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 4364) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 252125-1) |
| Enumeration Date | 2013-04-03 |
| Last Update Date | 2013-04-03 |