| 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 |