| NPI | 1265520241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L3698) |
| Additional Taxonomies | 104100000X Social Worker (Licence: OR 3698) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR L3698) | |
| 101YM0800X Counselor, Mental Health (Licence: OR L3698) | |
| Enumeration Date | 2006-10-11 |
| Last Update Date | 2012-01-25 |