| NPI | 1427098045 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 11530) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WI 2359-057) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2007-07-09 |