| NPI | 1811400823 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 225400000X Rehabilitation Practitioner |
| Enumeration Date | 2017-11-13 |
| Last Update Date | 2020-03-18 |