| NPI | 1093726143 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 3516-123) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 1015) |
| 101YP2500X Counselor, Professional (Licence: WI 1595-125) | |
| Enumeration Date | 2006-08-11 |
| Last Update Date | 2013-04-15 |