| 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 |