| NPI | 1194848663 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 53340)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 11005)  | 
| 1041C0700X Social Worker, Clinical (Licence: OK 3443)  | |
| 104100000X Social Worker (Licence: OK 2817)  | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OK 249)  | |
| Enumeration Date | 2007-04-09 | 
| Last Update Date | 2011-09-12 |