| NPI | 1689095036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD AC1194) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: MD LC4351) |
| Enumeration Date | 2014-01-02 |
| Last Update Date | 2017-02-16 |