| NPI | 1255685764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WV 3179) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WV 15-312) |
| 104100000X Social Worker (Licence: WV AP00942661) | |
| Enumeration Date | 2012-11-06 |
| Last Update Date | 2025-12-11 |