| NPI | 1386916070 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 3478) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC 9061) |
| Enumeration Date | 2012-01-27 |
| Last Update Date | 2015-02-09 |