| NPI | 1194022970 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: SD 3634) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NY 12682) |
| 104100000X Social Worker (Licence: NY 079673) | |
| Enumeration Date | 2011-02-14 |
| Last Update Date | 2019-01-24 |