| NPI | 1801329065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 18010-130) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 15230-136) |
| Enumeration Date | 2017-04-05 |
| Last Update Date | 2017-04-05 |