| NPI | 1124539713 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16213) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 130560) |
| Enumeration Date | 2017-10-23 |
| Last Update Date | 2017-10-23 |