| NPI | 1396875407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WV 1332) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: OH E1852) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WV 99-305) | |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2007-07-08 |