| NPI | 1962434647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 000189) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: VT 068-0000617) |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2011-05-16 |