| NPI | 1669506846 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 4187-125) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 14743133) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15306-132) | |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2010-09-27 |