| NPI | 1104004282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 13164) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD 13164) |
| 104100000X Social Worker (Licence: MD 13164) | |
| Enumeration Date | 2008-01-31 |
| Last Update Date | 2013-01-28 |