| NPI | 1629068192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: WI 4693-125) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 11704-132) |
| 1041C0700X Social Worker, Clinical (Licence: WI 11704) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2021-01-21 |