| NPI | 1790235778 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-22672) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: NC A12849) |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2018-09-06 |