| NPI | 1396124640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SC 11286) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: SC 507765) |
| Enumeration Date | 2015-05-20 |
| Last Update Date | 2017-02-15 |