| NPI | 1396183273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: IN 28125454A) |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2013-06-12 |