| NPI | 1467619312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1236510816) |
| Additional Taxonomies | 167G00000X Licensed Psychiatric Technician (Licence: CA 30111) |
| Enumeration Date | 2008-05-19 |
| Last Update Date | 2018-08-02 |