| NPI | 1912088121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: LA 868) |
| Additional Taxonomies | 163WA0400X Registered Nurse Addiction (Substance Use Disorder) (Licence: LA RN046513) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2023-09-06 |