| NPI | 1447428206 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ 10475) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 2013) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 0762AL) | |
| 101YM0800X Counselor, Mental Health (Licence: AZ 201801) | |
| Enumeration Date | 2008-02-14 |
| Last Update Date | 2008-02-14 |