| NPI | 1932531894 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: NC 9688) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 3221) |
| 163W00000X Registered Nurse (Licence: NC 147098) | |
| Enumeration Date | 2013-08-02 |
| Last Update Date | 2020-07-08 |