| NPI | 1477903524 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 17892) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 3091) |
| Enumeration Date | 2016-06-20 |
| Last Update Date | 2017-02-14 |