| NPI | 1629052675 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: IN 34001751) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IN 34001751) |
| 101YM0800X Counselor Mental Health (Licence: IN 34001751) | |
| Enumeration Date | 2005-12-02 |
| Last Update Date | 2015-01-23 |