| NPI | 1558494757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: NC 4457) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 987) |
| 101YP2500X Counselor, Professional (Licence: NC 4457) | |
| Enumeration Date | 2007-03-14 |
| Last Update Date | 2010-02-09 |