| NPI | 1134470743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 22860) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: RI CSW03141) |
| Enumeration Date | 2012-09-21 |
| Last Update Date | 2025-02-17 |