| NPI | 1619412582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 18-P-25) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR G21-01-07) |
| Enumeration Date | 2016-12-30 |
| Last Update Date | 2024-01-04 |