| NPI | 1659538361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15632-132) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 13990) |
| 101YM0800X Counselor, Mental Health (Licence: WI 6823-125) | |
| Enumeration Date | 2008-05-20 |
| Last Update Date | 2018-03-14 |