| NPI | 1972087146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 229046) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 229046-30) |
| Enumeration Date | 2018-09-24 |
| Last Update Date | 2022-08-18 |