| NPI | 1679505820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WV DP00942732) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 1811) |
| 104100000X Social Worker (Licence: TN 6859) | |
| 1041C0700X Social Worker Clinical (Licence: OH S0014427) | |
| 1041C0700X Social Worker Clinical (Licence: DC LC50079790) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2013-09-29 |