| NPI | 1528165578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KS 2028) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS LCAC 540) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2016-06-21 |