| NPI | 1518014570 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WV 87-101) |
| Additional Taxonomies | 101YP2500X Counselor, Professional (Licence: WV 1366) |
| 104100000X Social Worker (Licence: WV AP00451580) | |
| Enumeration Date | 2007-01-04 |
| Last Update Date | 2007-07-08 |