| NPI | 1114255361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15863-130) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 10300-120) |
| Enumeration Date | 2009-11-30 |
| Last Update Date | 2009-11-30 |