| NPI | 1356578090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L5347) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 11-09-89U3) |
| Enumeration Date | 2009-06-21 |
| Last Update Date | 2013-07-05 |