| NPI | 1861704306 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 19010) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 4129-125) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15344-132) | |
| Enumeration Date | 2010-07-13 |
| Last Update Date | 2010-12-27 |