| NPI | 1205114394 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: WV AP00942568) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WV 10-100) |
| Enumeration Date | 2011-07-25 |
| Last Update Date | 2011-07-25 |