| NPI | 1487091419 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CA MFC 18427) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NV 00119-G) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NV 00104LC) | |
| Enumeration Date | 2013-05-31 |
| Last Update Date | 2013-05-31 |