| NPI | 1376942441 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MS 1738) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MS 0101) |
| Enumeration Date | 2014-08-14 |
| Last Update Date | 2014-08-14 |