| NPI | 1639246382 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: WI 3182) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 1554) |
| 101Y00000X Counselor (Licence: WI 3182-123) | |
| Enumeration Date | 2006-11-29 |
| Last Update Date | 2018-02-21 |