| NPI | 1154311637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 081794) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO 5510) |
| 1041C0700X Social Worker, Clinical (Licence: CO 992876) | |
| Enumeration Date | 2005-10-25 |
| Last Update Date | 2019-01-10 |