| NPI | 1962640987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor (Licence: WY lpc-1440) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR T-17-376) |
| Enumeration Date | 2009-01-29 |
| Last Update Date | 2019-01-24 |