| NPI | 1639302490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IA 098724) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 21999) |
| 1041C0700X Social Worker, Clinical (Licence: NC P008933) | |
| 227800000X Respiratory Therapist, Certified (Licence: NC A-3745) | |
| Enumeration Date | 2009-08-27 |
| Last Update Date | 2020-06-25 |