| NPI | 1417943390 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT 832) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MT 469LCSW) |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2007-07-08 |