| NPI | 1124164314 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NY 070588-1) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 3302) |
| 1041C0700X Social Worker, Clinical (Licence: NJ 44SC01383300) | |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2011-07-19 |