| NPI | 1316235757 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L6121) | 
| Additional Taxonomies | 171M00000X Case Manager/Care Coordinator | 
| 101YM0800X Counselor, Mental Health | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2011-07-19 | 
| Last Update Date | 2016-07-11 |