| NPI | 1841576048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ID 703250) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR AP-04-04-10-10) |
| Enumeration Date | 2011-11-01 |
| Last Update Date | 2011-11-01 |