| NPI | 1508031907 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: HI 3865) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: HI NO NUMBER) |
| Enumeration Date | 2008-04-25 |
| Last Update Date | 2014-01-23 |