| NPI | 1124399530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: NE 1810) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NE 4337) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 1223) | |
| Enumeration Date | 2012-01-17 |
| Last Update Date | 2022-07-21 |