| NPI | 1023172194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: FL SW8479) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: FL CAP 3004) |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2016-07-21 |