| NPI | 1538407028 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: SC 6880) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: SC 12033036) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: SC 111) | |
| Enumeration Date | 2013-01-18 |
| Last Update Date | 2021-07-28 |