| NPI | 1043515331 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: VA 0904007534) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: VA 0812000607) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: VA 0710102377) | |
| Enumeration Date | 2011-01-18 |
| Last Update Date | 2011-01-18 |