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 |