| NPI | 1831248764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 86036) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IA 11002) |
| 1041C0700X Social Worker, Clinical (Licence: IA 03644) | |
| 163W00000X Registered Nurse (Licence: IA 064787) | |
| Enumeration Date | 2007-01-09 |
| Last Update Date | 2007-07-08 |