| NPI | 1861629735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: GA LPN090192) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 164X00000X Licensed Vocational Nurse (Licence: CA VN237459) | |
| Enumeration Date | 2009-06-17 |
| Last Update Date | 2022-07-21 |