| NPI | 1366681348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: AZ LCSW-11229) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: AZ LISAC-11454) |
| Enumeration Date | 2009-02-13 |
| Last Update Date | 2009-02-13 |