| NPI | 1881148112 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: UT 6300986-6006) |
| Additional Taxonomies | 174400000X Specialist (Licence: UT 6300986-5001) |
| Enumeration Date | 2016-08-03 |
| Last Update Date | 2016-08-03 |