| NPI | 1639637325 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 17-11-04) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: OR 200341401RN) |
| Enumeration Date | 2019-03-12 |
| Last Update Date | 2019-03-12 |