| NPI | 1336172287 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904003115)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0710000240)  | 
| Enumeration Date | 2006-07-07 | 
| Last Update Date | 2008-04-29 |