| NPI | 1679085203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: RI 101YA0400X.) |
| Enumeration Date | 2017-11-06 |
| Last Update Date | 2020-04-02 |