| NPI | 1356760557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MT BBH-LAC-LIC-42619) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 15683-132) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2020-05-06 |