| NPI | 1053339929 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0718000078)  | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: VA 0904002405)  | 
| Enumeration Date | 2006-07-18 | 
| Last Update Date | 2025-09-11 |