| NPI | 1679616197 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR 4151) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 00-07-03) |
| Enumeration Date | 2007-02-14 |
| Last Update Date | 2008-03-31 |