| NPI | 1205122124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C007813) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS1822) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 1822) | |
| Enumeration Date | 2011-06-20 |
| Last Update Date | 2022-03-22 |