| NPI | 1649619040 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: HI 3516) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: HI 1738-13) |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2013-06-19 |