| NPI | 1043598659 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: OR L7328) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: CA 74768) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor Mental Health (Licence: OR L7328) | |
| Enumeration Date | 2011-07-31 |
| Last Update Date | 2019-01-03 |