| NPI | 1437263969 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 000040) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CT 004216) |
| 164W00000X Licensed Practical Nurse (Licence: CT 018594) | |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2007-07-09 |