| NPI | 1497866297 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 2180 RU) |
| Additional Taxonomies | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: IN 70000124A) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-08 |