NPI | 1083973549 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MI 6801092795) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MI 6801092795) |
Enumeration Date | 2012-05-03 |
Last Update Date | 2012-05-03 |