| NPI | 1659389443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: VT 089-0000494) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: VT 089-0000494) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 089-0000494) | |
| 103T00000X Psychologist (Licence: VT 089-0000494) | |
| 1041C0700X Social Worker, Clinical (Licence: VT 089-0000494) | |
| Enumeration Date | 2006-08-04 |
| Last Update Date | 2008-03-10 |