| NPI | 1629511514 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA RN665405) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 26NR15196500) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0001093481) | |
| Enumeration Date | 2016-11-23 |
| Last Update Date | 2016-11-23 |