| NPI | 1790911659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ AZDBHS #CC0545) |
| Additional Taxonomies | 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) (Licence: AZ RN015602) |
| Enumeration Date | 2009-06-05 |
| Last Update Date | 2009-06-05 |