| NPI | 1922420991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL ADC-010829-2015) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: FL 4697) |
| 101Y00000X Counselor (Licence: FL 4697) | |
| Enumeration Date | 2014-01-10 |
| Last Update Date | 2016-06-17 |