| NPI | 1205113602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: PA CW017281) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0710102630) |
| 1041C0700X Social Worker, Clinical (Licence: VA 0904007355) | |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2015-08-03 |