| NPI | 1114092145 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 1041C0700X Social Worker, Clinical (Licence: OR L4517) | |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2012-12-21 |