| NPI | 1952801854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ACB.0008180) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: CO RN.1624661) |
| 101YP2500X Counselor, Professional (Licence: LPC.0013370) | |
| Enumeration Date | 2018-02-16 |
| Last Update Date | 2018-02-16 |