| NPI | 1194271122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: SC 11811) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 24172) |
| 101YP2500X Counselor, Professional (Licence: NC P012152) | |
| Enumeration Date | 2016-08-30 |
| Last Update Date | 2019-08-15 |