| NPI | 1760633077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: PR AC-III-12-48-524) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 3245S0500X Substance Abuse Rehabilitation Facility Substance Abuse Treatment, Children | |
| Enumeration Date | 2008-10-06 |
| Last Update Date | 2008-10-06 |