| NPI | 1669772810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 8320) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 15402-132) |
| 1041C0700X Social Worker Clinical (Licence: WI 128989-121) | |
| Enumeration Date | 2010-10-21 |
| Last Update Date | 2019-01-09 |