| NPI | 1962514869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: RI MHC00235) |
| Additional Taxonomies | 103TA0400X Psychologist Addiction (Substance Use Disorder) (Licence: RI LCDP00129) |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2019-06-26 |