| NPI | 1700097516 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA RW0767) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: CA VN246830) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2010-06-29 |