NPI | 1194964577 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW8560) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL CAP 4906) |
Enumeration Date | 2009-02-09 |
Last Update Date | 2010-07-01 |