| NPI | 1629373568 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: ID LSW-30781) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ID 11540036) |
| Enumeration Date | 2011-01-25 |
| Last Update Date | 2011-01-25 |