| NPI | 1528376159 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101Y00000X Counselor |
| 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: CA 94022135) | |
| Enumeration Date | 2010-09-16 |
| Last Update Date | 2019-08-07 |