| NPI | 1235263484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: RI CDS00049) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA LADC I-1072) |
| 1041C0700X Social Worker, Clinical (Licence: RI CSW00684) | |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2007-07-08 |