| NPI | 1255446498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: KS LSCSW 2135) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: KS LCAC 186) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2012-04-27 |