| NPI | 1750442638 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: CT 001489) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 000748) |
| 101Y00000X Counselor (Licence: CT SA-0215) | |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2011-12-21 |