| NPI | 1811956428 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: CO 2994) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CO 5911) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2012-01-26 |