| NPI | 1487896429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: RI MHC00474) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: RI CDP00479) |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2011-04-26 |