| NPI | 1538611512 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: PR 11194) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PR 05-20-5665) |
| Enumeration Date | 2016-10-26 |
| Last Update Date | 2016-10-26 |