| NPI | 1396835336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 9170) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: RI PC198) |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2015-04-01 |