| NPI | 1205910239 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34005702A)  | 
| Additional Taxonomies | 101Y00000X Counselor | 
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| 101YM0800X Counselor, Mental Health | |
| 104100000X Social Worker | |
| Enumeration Date | 2006-10-25 | 
| Last Update Date | 2019-05-16 |