| NPI | 1174510580 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MO 2000168346) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: KS CADC1 (PENDING)) |
| 104100000X Social Worker (Licence: KS 2156) | |
| 104100000X Social Worker (Licence: MO 2000168346) | |
| Enumeration Date | 2005-09-30 |
| Last Update Date | 2014-12-15 |