| NPI | 1194178012 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SC 11792 LMSW) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: SC 11792 LMSW) |
| Enumeration Date | 2016-07-15 |
| Last Update Date | 2016-07-15 |