| NPI | 1588744361 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0718000073) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: VA 0904003883) |
| 1041C0700X Social Worker, Clinical (Licence: CO 91) | |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2007-07-08 |