| NPI | 1356522189 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MT 896) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT 1059) |
| Enumeration Date | 2007-11-20 |
| Last Update Date | 2012-03-21 |