| NPI | 1669925707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA LAC1355) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: LA PLC7007) |
| Enumeration Date | 2016-07-25 |
| Last Update Date | 2017-04-05 |