| NPI | 1063498087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 1191121) |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2007-07-08 |