| NPI | 1649543638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA CAC 985) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: LA CCGC 1049) |
| Enumeration Date | 2012-02-22 |
| Last Update Date | 2012-02-22 |