| NPI | 1477847960 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD.0000053) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CO LPC-2510) |
| Enumeration Date | 2011-06-02 |
| Last Update Date | 2020-07-13 |