| NPI | 1396142535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 3954) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 1336) |
| 1041C0700X Social Worker, Clinical (Licence: OH I.1440416) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OH 131178) | |
| Enumeration Date | 2014-12-03 |
| Last Update Date | 2014-12-04 |