| NPI | 1720282155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 7138) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CO 162465) |
| 101YP2500X Counselor, Professional (Licence: CO 6391) | |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2012-07-16 |