| NPI | 1508008038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: NC CO12183) |
| Additional Taxonomies | 101YP2500X Counselor Professional (Licence: NC 16481) |
| 1041C0700X Social Worker Clinical (Licence: NC PO11307) | |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 16481) | |
| Enumeration Date | 2009-03-30 |
| Last Update Date | 2019-05-02 |