| NPI | 1770689317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: OR C1512) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OR 00-03-28) |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2020-11-18 |