| NPI | 1508822396 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 3671-123) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 3671-123 and 1377) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 1377-132) | |
| Enumeration Date | 2006-04-21 |
| Last Update Date | 2011-01-19 |