| NPI | 1649697988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 17042-130) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 973-226) |
| Enumeration Date | 2014-03-25 |
| Last Update Date | 2014-03-25 |