| NPI | 1396760336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: LA CCS#010) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA 830) |
| 163W00000X Registered Nurse (Licence: LA RN071762) | |
| Enumeration Date | 2006-07-12 |
| Last Update Date | 2007-07-08 |