| NPI | 1629326483 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: IL 149017301) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IL 30341) |
| Enumeration Date | 2012-08-27 |
| Last Update Date | 2015-01-27 |