| NPI | 1922406610 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 2932A) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health (Licence: NC A10167) |
| Enumeration Date | 2014-12-11 |
| Last Update Date | 2014-12-11 |