| NPI | 1124140223 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 14233-130) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 127108-121) |
| Enumeration Date | 2007-04-06 |
| Last Update Date | 2007-07-08 |