| NPI | 1609912559 |
|---|---|
| Former Name | NICOLE HELENE LAVIN |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 7319-123) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 13989) |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2010-10-05 |