| NPI | 1164700381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CT 795) |
| Additional Taxonomies | 104100000X Social Worker (Licence: CT 7542) |
| Enumeration Date | 2011-07-22 |
| Last Update Date | 2011-07-22 |