| NPI | 1518069814 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 1893A) |
| Additional Taxonomies | 104100000X Social Worker (Licence: MA 103218) |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2007-07-08 |