| NPI | 1508157413 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 08-08-57U)  | 
| 101YM0800X Counselor, Mental Health (Licence: OR L2891)  | |
| Enumeration Date | 2011-04-26 | 
| Last Update Date | 2022-06-17 |