| NPI | 1457407918 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 171000000X Military Health Care Provider |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 95-10-06) |
| Enumeration Date | 2007-01-26 |
| Last Update Date | 2007-07-08 |