| NPI | 1780914127 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CT 001492) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CT 000950) |
| Enumeration Date | 2010-01-07 |
| Last Update Date | 2016-12-02 |