| NPI | 1568768174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 302R00000X Health Maintenance Organization |
| Enumeration Date | 2011-01-28 |
| Last Update Date | 2011-01-28 |