| NPI | 1669859336 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT 2635) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: MT 12402) |
| Enumeration Date | 2015-05-01 |
| Last Update Date | 2019-08-24 |