| NPI | 1336529957 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC P009579) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC lcas-21233) | 
| 104100000X Social Worker (Licence: NC p009579) | |
| Enumeration Date | 2015-06-09 | 
| Last Update Date | 2015-06-09 |