| NPI | 1487869780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15592) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 5579) |
| Enumeration Date | 2007-05-11 |
| Last Update Date | 2015-11-10 |