| NPI | 1528235975 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: AZ 12510)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ 10608)  | 
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NH 0612)  | |
| Enumeration Date | 2008-05-14 | 
| Last Update Date | 2016-12-15 |