| NPI | 1033369459 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: OR L10216) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OR 11-03-71) |
| Enumeration Date | 2008-09-22 |
| Last Update Date | 2023-03-23 |