| NPI | 1790119063 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LASAC-13027) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ ICADC 711815) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ CADAC 2071) | |
| Enumeration Date | 2013-08-22 |
| Last Update Date | 2013-08-22 |