| NPI | 1508080789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: CA 37-07) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2007-07-08 |