| NPI | 1134197940 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: UT 270969-3501) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: UT 270969-6008) |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2018-11-07 |