| NPI | 1629573258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC A13710) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCASA24130) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2018-03-26 |