| NPI | 1255673190 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA 004800) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA 0947) |
| Enumeration Date | 2013-03-18 |
| Last Update Date | 2013-03-18 |