| NPI | 1255842670 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904010294) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: 2168) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0710103164) | |
| Enumeration Date | 2017-10-12 |
| Last Update Date | 2018-07-12 |