| NPI | 1114356508 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34006733A)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 87001534A)  | 
| Enumeration Date | 2013-11-05 | 
| Last Update Date | 2020-02-14 |