| NPI | 1750653226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 16107-130) |
| Enumeration Date | 2012-01-31 |
| Last Update Date | 2013-03-05 |