| NPI | 1699273953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 374700000X Technician (Licence: CA CI20610918) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA R1240641016) |
| Enumeration Date | 2018-01-31 |
| Last Update Date | 2020-02-03 |