NPI | 1417257882 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: IL 149007053) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IL 11424) |
Enumeration Date | 2010-11-01 |
Last Update Date | 2010-11-01 |