| NPI | 1700287851 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: MI 6401014963) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MI 6401014963) | |
| Enumeration Date | 2014-09-09 |
| Last Update Date | 2019-10-21 |