| 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 |