| NPI | 1518097732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 12131-131) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WI 1286-057) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2007-07-08 |