| NPI | 1982910865 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: IL 180-006871) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: IL 180.006871) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 25786) | |
| Enumeration Date | 2010-08-30 |
| Last Update Date | 2013-07-30 |