| NPI | 1801451463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: MI 4703095538) |
| Additional Taxonomies | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: MI 4703095538) |
| 364SR0400X Clinical Nurse Specialist Rehabilitation (Licence: MI 4703095538) | |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2019-05-08 |