| NPI | 1487740874 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 2-00894) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: TX 8231) |
| Enumeration Date | 2006-10-05 |
| Last Update Date | 2010-12-02 |