| NPI | 1780940890 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NH MLADC 0572) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WA CP 60211219) |
| Enumeration Date | 2012-04-03 |
| Last Update Date | 2014-01-02 |