| NPI | 1639504194 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C10190) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC A22125) |
| 1041C0700X Social Worker, Clinical (Licence: CA ASW36503) | |
| Enumeration Date | 2013-09-03 |
| Last Update Date | 2020-05-18 |