| NPI | 1366477473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA 581) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: LA 108) |
| Enumeration Date | 2006-07-11 |
| Last Update Date | 2007-10-23 |