| NPI | 1053337592 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C006055) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: SC 06223) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SC 64648) | |
| Enumeration Date | 2006-07-15 |
| Last Update Date | 2016-10-25 |