| NPI | 1760634232 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MO 5087) |
| Additional Taxonomies | 247200000X Technician, Other |
| Enumeration Date | 2008-10-16 |
| Last Update Date | 2011-07-27 |