| NPI | 1700123452 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ND 1635) |
| Additional Taxonomies | 104100000X Social Worker (Licence: ND 3008) |
| Enumeration Date | 2013-01-14 |
| Last Update Date | 2013-01-14 |