| NPI | 1114131125 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CO 939) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CO ACB0006428) |
| Enumeration Date | 2007-05-09 |
| Last Update Date | 2016-05-24 |