| NPI | 1396997011 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT 1264) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: MT 577) |
| Enumeration Date | 2008-10-13 |
| Last Update Date | 2008-10-13 |