| NPI | 1578853552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 12849-131) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 7382-120) |
| Enumeration Date | 2011-04-12 |
| Last Update Date | 2011-04-12 |