| NPI | 1972830123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LADC#0608) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NH MED#0608) |
| Enumeration Date | 2009-11-09 |
| Last Update Date | 2021-11-02 |