| NPI | 1053335398 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OR 07-09-02) | |
| Enumeration Date | 2006-07-27 |
| Last Update Date | 2007-11-28 |