| NPI | 1548341324 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 2045) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: MA 50018) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2007-07-08 |