| NPI | 1609992221 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: OR L4479) |
| Additional Taxonomies | 104100000X Social Worker |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OR 091229) | |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2017-03-13 |