| NPI | 1508170010 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA J0902201133) |
| Additional Taxonomies | 374700000X Technician (Licence: CA J0902201133) |
| Enumeration Date | 2010-07-27 |
| Last Update Date | 2015-01-21 |