| NPI | 1225073323 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WV CP00450536) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WV 94-304) |
| 104100000X Social Worker (Licence: WV CP00450536) | |
| Enumeration Date | 2006-06-20 |
| Last Update Date | 2007-09-25 |