| NPI | 1730324138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: PA 452) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: PA 2696) |
| Enumeration Date | 2008-12-14 |
| Last Update Date | 2011-04-06 |