| NPI | 1013259068 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WV DP00944084) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WV 11-105) |
| 101YP1600X Counselor, Pastoral | |
| Enumeration Date | 2013-03-17 |
| Last Update Date | 2014-10-16 |