| NPI | 1396149787 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACC0003618) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 0074855) |
| Enumeration Date | 2014-10-15 |
| Last Update Date | 2014-10-15 |