| NPI | 1518093954 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI C-00080) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: MI 6301013460) |
| 1041C0700X Social Worker, Clinical (Licence: MI 6802084189) | |
| Enumeration Date | 2007-02-27 |
| Last Update Date | 2007-07-08 |