| NPI | 1679911499 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NC A-11525) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 23477-A) |
| Enumeration Date | 2013-06-14 |
| Last Update Date | 2022-07-21 |