| NPI | 1952852022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 17705) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 130284) |
| Enumeration Date | 2016-10-24 |
| Last Update Date | 2016-10-24 |