| NPI | 1548585060 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NC C006953) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 3133A) |
| 101YM0800X Counselor Mental Health (Licence: NC C006953) | |
| Enumeration Date | 2010-03-29 |
| Last Update Date | 2018-06-13 |