| NPI | 1750491429 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MO 1989) |
| Additional Taxonomies | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: MO 089783) |
| 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: IL 209005503) | |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2007-07-08 |