| NPI | 1598069031 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OK 4716) | 
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: OK 1063) | 
| Enumeration Date | 2010-12-24 | 
| Last Update Date | 2019-01-30 |