| NPI | 1225360290 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C010237) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: NC P00900) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 15023) | |
| Enumeration Date | 2010-02-02 |
| Last Update Date | 2019-08-28 |