| NPI | 1467688309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: KS 2247) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MO 2000174744) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 397) | |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2014-01-13 |