| NPI | 1639400823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 109) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: CO 4843) |
| Enumeration Date | 2010-01-27 |
| Last Update Date | 2010-02-15 |