| NPI | 1346230695 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: WI 6502-120) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: WI 6502-120) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15743-130) | |
| Enumeration Date | 2005-10-27 |
| Last Update Date | 2010-05-20 |