| NPI | 1518143700 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180.007373) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 178004592) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 21014) | |
| Enumeration Date | 2008-01-17 |
| Last Update Date | 2012-03-19 |