| NPI | 1497823058 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: VT 000193) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: VT 068-0000166) |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2011-05-16 |