| NPI | 1962626721 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 905) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MA 122) |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2007-07-08 |