| NPI | 1013937341 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 6969-123) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 12605-131) |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2008-05-26 |