| NPI | 1366520348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 106) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MA 115639) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2007-07-08 |