| NPI | 1407981640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OK 381) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: OK 3351) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2012-05-25 |