| NPI | 1114112133 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: OR L7749) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CO ACC-4913) |
| 1041C0700X Social Worker Clinical (Licence: CO CSW-869) | |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2025-08-22 |