| NPI | 1568604635 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: PA PC002235) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA 3042) |
| Enumeration Date | 2009-04-03 |
| Last Update Date | 2009-04-03 |