| NPI | 1194023168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 1774) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC P-005960) |
| Enumeration Date | 2011-03-01 |
| Last Update Date | 2011-03-01 |