| NPI | 1639113871 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 14482) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: FL SW8864) |
| Enumeration Date | 2006-06-16 |
| Last Update Date | 2009-05-04 |