| NPI | 1013439975 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IL 149.019521) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IL 33553) | 
| Enumeration Date | 2017-07-12 | 
| Last Update Date | 2018-10-29 |