| NPI | 1457643827 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15673-130) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 129264) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15706) | |
| Enumeration Date | 2011-05-04 |
| Last Update Date | 2016-10-12 |