| NPI | 1811384241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 7634-125) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16284-132) |
| 101YP2500X Counselor, Professional (Licence: WI 3943-226) | |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2021-01-22 |