| NPI | 1275590226 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 865-123) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 1749-125) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15519-132) | |
| Enumeration Date | 2006-04-26 |
| Last Update Date | 2016-05-12 |