| NPI | 1629353560 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 2775) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC P006539) |
| Enumeration Date | 2011-10-11 |
| Last Update Date | 2013-01-02 |