| NPI | 1396169843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: IA 007427) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IA 12057) |
| 104100000X Social Worker (Licence: IA 007427) | |
| Enumeration Date | 2014-02-04 |
| Last Update Date | 2019-01-03 |