| NPI | 1205017563 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ND 1690) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: ND 4736) |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2012-11-21 |