| NPI | 1568779916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 18-08-32) |
| Additional Taxonomies | 172M00000X Mechanotherapist (Licence: OR 14427) |
| Enumeration Date | 2010-09-07 |
| Last Update Date | 2019-07-24 |