| NPI | 1407153547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 8139526-3506) |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: UT 8139526-6006) | |
| Enumeration Date | 2011-02-25 |
| Last Update Date | 2016-11-16 |