| NPI | 1730567421 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CA C6451214) |
| Additional Taxonomies | 374700000X Technician (Licence: CA C6451214) |
| Enumeration Date | 2015-05-13 |
| Last Update Date | 2020-01-29 |