| NPI | 1619431350 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: PA PC010525) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA 12502) |
| Enumeration Date | 2019-01-28 |
| Last Update Date | 2019-11-07 |