| NPI | 1649695396 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NJ 44SC05493200) | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC00193500) | 
| Enumeration Date | 2014-03-04 | 
| Last Update Date | 2014-03-04 |