| NPI | 1245411057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L5455) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 11-09-71) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2007-11-20 |
| Last Update Date | 2012-09-04 |