| NPI | 1578195285 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ID 11586) | 
| Additional Taxonomies | 104100000X Social Worker (Licence: ID LSW-34811) | 
| Enumeration Date | 2020-02-11 | 
| Last Update Date | 2020-02-11 |