| NPI | 1477912640 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NY 29716) |
| Additional Taxonomies | 101YS0200X Counselor School (Licence: NY 2543303) |
| Enumeration Date | 2016-02-17 |
| Last Update Date | 2016-02-17 |