| NPI | 1568786770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WY 634) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WY 340) |
| 1041C0700X Social Worker, Clinical (Licence: ND 4975) | |
| Enumeration Date | 2010-03-16 |
| Last Update Date | 2021-05-21 |