| NPI | 1598036600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA 006663) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA 2010-R) |
| Enumeration Date | 2012-01-20 |
| Last Update Date | 2022-11-25 |