| NPI | 1710281050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 16149-130) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: WI 926-226) |
| Enumeration Date | 2010-12-30 |
| Last Update Date | 2012-09-04 |