| NPI | 1962869842 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: MD LC8740) |
| Enumeration Date | 2016-01-22 |
| Last Update Date | 2018-06-22 |