| NPI | 1831556695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 166387) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: KY 165123) |
| Enumeration Date | 2016-01-25 |
| Last Update Date | 2019-12-27 |