| 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 | 2007-07-08 |