| NPI | 1912551698 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AK 31662) |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2022-10-31 |