| NPI | 1821150061 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PR 297) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: PR 5496) |
| Enumeration Date | 2006-12-14 |
| Last Update Date | 2014-11-25 |