| NPI | 1326179771 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 2583-123) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WI 308-125) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 12077-131) | |
| Enumeration Date | 2007-03-08 |
| Last Update Date | 2018-03-17 |