| NPI | 1629329024 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NE 1242) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 1139) |
| 101YM0800X Counselor, Mental Health (Licence: NE 1198) | |
| Enumeration Date | 2012-09-25 |
| Last Update Date | 2016-12-30 |