NPI | 1538414180 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NJ 44SC05467700) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NM 37LC00244000) |
Enumeration Date | 2012-07-19 |
Last Update Date | 2017-01-11 |