| NPI | 1295766186 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 969-123) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 2045) |
| 1041C0700X Social Worker Clinical (Licence: IL 149-005163) | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2008-11-25 |