| NPI | 1699036095 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MI 6401013030) |
| Additional Taxonomies | 101YP2500X Counselor Professional |
| Enumeration Date | 2012-06-01 |
| Last Update Date | 2012-06-01 |