| NPI | 1861615759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 13486-130) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 3903-125) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2007-07-09 |