| NPI | 1558414300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WV 1279) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WV 98-102) |
| 104100000X Social Worker (Licence: WV AP00940434) | |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-09-08 |