NPI | 1376852699 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: IL 149.012149) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IL 203890) |
Enumeration Date | 2010-10-04 |
Last Update Date | 2012-12-12 |