| NPI | 1306922612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 000046) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: VT 047-0000159) |
| 1041C0700X Social Worker, Clinical (Licence: VT 089-0000192) | |
| Enumeration Date | 2006-10-29 |
| Last Update Date | 2009-06-12 |