| NPI | 1255638409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 350052-3502) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: UT 350052-6006) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2011-02-24 |
| Last Update Date | 2013-08-13 |