| NPI | 1114174323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NY 078115) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: FL SW16540) |
| Enumeration Date | 2008-08-20 |
| Last Update Date | 2021-02-24 |