| NPI | 1821368754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15855) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 5755) |
| Enumeration Date | 2012-01-10 |
| Last Update Date | 2015-11-09 |