| NPI | 1053647891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 2792A) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NC P005376) |
| Enumeration Date | 2009-10-29 |
| Last Update Date | 2020-05-01 |