| NPI | 1487959912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15541-132) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 8187) |
| Enumeration Date | 2011-01-13 |
| Last Update Date | 2016-06-20 |