| NPI | 1639538572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-21879) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC A15144) |
| 101YP2500X Counselor, Professional (Licence: MD LGP9798) | |
| Enumeration Date | 2016-02-21 |
| Last Update Date | 2019-10-09 |