| NPI | 1043630650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 335) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KS 6929) |
| Enumeration Date | 2014-04-22 |
| Last Update Date | 2014-04-22 |