NPI | 1669842563 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 171W00000X Contractor (Licence: AR 140495) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: AR 026) |
Enumeration Date | 2015-10-05 |
Last Update Date | 2015-10-08 |