| NPI | 1164467833 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MT 23622) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NM 0078241) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MT 29342) | |
| 1041C0700X Social Worker Clinical (Licence: NM I-05966) | |
| Enumeration Date | 2006-06-18 |
| Last Update Date | 2019-01-29 |