| NPI | 1568867505 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 222Q00000X Developmental Therapist |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 3344) |
| Enumeration Date | 2014-11-04 |
| Last Update Date | 2015-04-02 |