| NPI | 1740705391 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 146N00000X Emergency Medical Technician, Basic (Licence: MI 2000271) |
| Enumeration Date | 2017-08-04 |
| Last Update Date | 2017-08-11 |