| NPI | 1639479405 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR A5749) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 07-12-56 CADCII) |
| Enumeration Date | 2010-10-27 |
| Last Update Date | 2022-01-13 |