| NPI | 1174905160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NC C010880) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NC P009657) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| Enumeration Date | 2015-06-25 |
| Last Update Date | 2019-07-23 |