| NPI | 1023232634 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MT LCSW 683) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MT LAC 1036) |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2007-08-13 |