| NPI | 1043572647 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05247300) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC00089600) |
| 101YP2500X Counselor, Professional (Licence: NJ 37PC00233300) | |
| Enumeration Date | 2012-06-11 |
| Last Update Date | 2013-04-24 |