| NPI | 1134507031 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SC 101YAO400X) |
| Additional Taxonomies | 104100000X Social Worker (Licence: SC 10789) |
| Enumeration Date | 2015-05-12 |
| Last Update Date | 2015-05-12 |