| NPI | 1013048636 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149002526)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 17392)  | 
| Enumeration Date | 2007-03-07 | 
| Last Update Date | 2015-05-11 |