| NPI | 1114250883 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: VT 0890058105) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: VT 089-00509) |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2015-08-12 |