| NPI | 1053754184 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WA SA60311558) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WA SA60311558) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WA CP60363732) | |
| Enumeration Date | 2013-04-08 |
| Last Update Date | 2013-05-03 |