| NPI | 1508193202 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NE 842) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NE 1458) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 268) | |
| 101YM0800X Counselor, Mental Health (Licence: NE 364) | |
| Enumeration Date | 2009-11-17 |
| Last Update Date | 2012-08-04 |