| NPI | 1497020069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NY 086054) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 086054) |
| Enumeration Date | 2012-03-15 |
| Last Update Date | 2012-10-16 |