| NPI | 1760737902 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 11-06-70) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101Y00000X Counselor (Licence: OR G 14-12-02) | |
| Enumeration Date | 2012-07-13 |
| Last Update Date | 2015-03-04 |