| NPI | 1396138897 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program (Licence: MD A0016) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD AC0374) |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2022-10-10 |