| NPI | 1679808935 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 15615-130) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 128008-121) |
| Enumeration Date | 2009-10-05 |
| Last Update Date | 2013-12-09 |