| NPI | 1497739486 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 12117) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 31078) |
| 1041C0700X Social Worker, Clinical (Licence: WI 605-121) | |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2014-03-05 |