| NPI | 1164535654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0710101902) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: VA 0904006264) |
| Enumeration Date | 2006-08-17 |
| Last Update Date | 2008-08-21 |