| NPI | 1851916423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CA R1399920820) |
| Additional Taxonomies | 106S00000X Behavior Technician (Licence: CA R1399920820) |
| 183700000X Pharmacy Technician (Licence: AZ T064283) | |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2020-09-13 |