| NPI | 1841602539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: RI 00136) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: RI 00075) |
| Enumeration Date | 2014-05-29 |
| Last Update Date | 2014-05-29 |