| NPI | 1386906469 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 080463) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 000987) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 26735) | |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2014-01-13 |