| NPI | 1447234562 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 45065) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: KS 45065) |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: KS 45065) | |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2007-07-08 |