| NPI | 1013938539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: LA 8839LCSW) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: LA 1041) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: FL 1178) | |
| 104100000X Social Worker (Licence: LA 8839) | |
| 101Y00000X Counselor (Licence: LA 1041LAC) | |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2010-06-02 |