| NPI | 1124033618 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L3197) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 98-07-34) | 
| Enumeration Date | 2006-07-31 | 
| Last Update Date | 2025-06-24 |