| NPI | 1770006793 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 12371) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 461772-1) |
| Enumeration Date | 2017-07-21 |
| Last Update Date | 2018-06-16 |