| NPI | 1417106550 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 11391) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NM 0085161) |
| Enumeration Date | 2008-09-12 |
| Last Update Date | 2015-10-09 |