| NPI | 1760765416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ND 1659) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: ND 873-4-15-16-365) |
| Enumeration Date | 2011-09-20 |
| Last Update Date | 2019-11-01 |