| NPI | 1770837692 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 2060) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: NC 9525) |
| Enumeration Date | 2012-10-30 |
| Last Update Date | 2017-04-12 |