| NPI | 1669440095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: RI MHC00056) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: RI CDP00208) |
| Enumeration Date | 2006-03-10 |
| Last Update Date | 2015-08-18 |