| NPI | 1912505702 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: NJ 37PC00304700) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC00234000) | 
| Enumeration Date | 2020-10-13 | 
| Last Update Date | 2020-10-13 |