| NPI | 1518127570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 247200000X Technician, Other |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI G320210031990) |
| Enumeration Date | 2008-06-12 |
| Last Update Date | 2016-09-16 |