| NPI | 1619079746 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MSWACB5417) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CA LCS15773) |
| 1041C0700X Social Worker, Clinical (Licence: OR LCSW1220) | |
| 1041C0700X Social Worker, Clinical (Licence: BCD27321) | |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2007-07-08 |