| NPI | 1598129413 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MT 13852) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MT 1324) |
| Enumeration Date | 2016-04-06 |
| Last Update Date | 2016-04-06 |