NPI | 1295955169 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MD AC0648) |
Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MD 12130) |
Enumeration Date | 2007-04-26 |
Last Update Date | 2007-07-08 |