| NPI | 1669662854 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: IA 006928) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IA 09026) |
| Enumeration Date | 2007-07-25 |
| Last Update Date | 2010-05-06 |