| NPI | 1578858411 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 09138) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: IA 001223) |
| Enumeration Date | 2011-06-17 |
| Last Update Date | 2023-01-09 |