| NPI | 1558419911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: CO 661) |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2007-07-08 |