| NPI | 1396971735 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR 4164) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 96-10-83) |
| Enumeration Date | 2009-05-29 |
| Last Update Date | 2018-05-17 |