| NPI | 1871885657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: OR T0351) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OR 96-R-41) |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2011-05-11 |