| NPI | 1164589222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 106868) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 146) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 106868) | |
| Enumeration Date | 2007-01-01 |
| Last Update Date | 2011-08-10 |