| NPI | 1376732545 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: OR C2515) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR CADC 1- 10-06-34) |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2021-12-28 |