| NPI | 1568818912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC 12307) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC A12307) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 23222) | |
| Enumeration Date | 2016-05-04 |
| Last Update Date | 2018-07-30 |