| NPI | 1376604942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SD 929301) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MN 929301) |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: MN 929301) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2024-04-19 |