| NPI | 1114243342 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WY LCSW-579) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WY LAT-305) |
| Enumeration Date | 2010-04-13 |
| Last Update Date | 2016-08-22 |