| NPI | 1912065152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 103TC1900X Psychologist Counseling (Licence: MI 6301009617) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2007-07-08 |