| NPI | 1285969675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 080792) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 079607) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 29370) | |
| Enumeration Date | 2009-10-02 |
| Last Update Date | 2015-08-14 |