| NPI | 1770628588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 873) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC 355) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2007-08-15 |