| NPI | 1952565020 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 000735) | 
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: CT 001880) | 
| Enumeration Date | 2008-07-17 | 
| Last Update Date | 2011-04-12 |