| NPI | 1649511007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 8292-123) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 128772-121) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15897-132) | |
| Enumeration Date | 2013-03-11 |
| Last Update Date | 2015-09-16 |