| NPI | 1154593192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 294122) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 2125132) |
| 106H00000X Marriage & Family Therapist (Licence: WI 579124) | |
| Enumeration Date | 2008-03-31 |
| Last Update Date | 2008-03-31 |