| NPI | 1750868162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 07065) |
| Additional Taxonomies | 104100000X Social Worker (Licence: IA 02803) |
| Enumeration Date | 2018-07-27 |
| Last Update Date | 2018-07-27 |