| NPI | 1659716124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT 2649) |
| Additional Taxonomies | 103K00000X Behavior Analyst |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2013-05-09 |
| Last Update Date | 2013-05-09 |