| NPI | 1225367287 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 007210) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 000686) |
| 101YP2500X Counselor, Professional (Licence: CT 000938) | |
| Enumeration Date | 2009-12-21 |
| Last Update Date | 2012-06-13 |