| NPI | 1518254416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: SC 5145) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SC 1105055) |
| 101YP2500X Counselor, Professional (Licence: NC 8163) | |
| 101YP2500X Counselor, Professional (Licence: NC 56127) | |
| Enumeration Date | 2011-06-30 |
| Last Update Date | 2011-06-30 |