| NPI | 1821358037 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6301006162) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MI 6301006162) |
| Enumeration Date | 2012-05-22 |
| Last Update Date | 2017-01-05 |