| NPI | 1710139332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 5350) |
| Additional Taxonomies | 225X00000X Occupational Therapist (Licence: CO 984828) |
| Enumeration Date | 2008-10-14 |
| Last Update Date | 2008-10-14 |