| NPI | 1376730986 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR L4576)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 11-06-94)  | 
| 1041C0700X Social Worker, Clinical (Licence: OR 4576)  | |
| Enumeration Date | 2007-09-27 | 
| Last Update Date | 2024-02-13 |