| NPI | 1689212862 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YS0200X Counselor School (Licence: MI SC0000001012118) |
| Enumeration Date | 2019-12-18 |
| Last Update Date | 2019-12-18 |