| NPI | 1588988158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: TN 4390) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TN 69) |
| Enumeration Date | 2010-03-25 |
| Last Update Date | 2010-03-25 |