| 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 |