| NPI | 1215309844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: VT 089-0102155) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: VT 151-0127779) |
| Enumeration Date | 2015-10-22 |
| Last Update Date | 2019-08-20 |