| NPI | 1376877860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 7935) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: CO 740) |
| Enumeration Date | 2009-09-30 |
| Last Update Date | 2009-09-30 |