| NPI | 1366787293 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 12739-132) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 8496-120) |
| Enumeration Date | 2012-12-04 |
| Last Update Date | 2012-12-04 |