| NPI | 1891212742 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16371-132) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: WI 5401-226) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 17416-130) | |
| Enumeration Date | 2017-08-22 |
| Last Update Date | 2022-08-25 |