| NPI | 1366682726 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: OR C2388) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OR 08-06-61) |
| Enumeration Date | 2009-02-25 |
| Last Update Date | 2012-12-18 |