| NPI | 1679819916 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: PA SW127489) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: PA SW127489) |
| 1041C0700X Social Worker, Clinical (Licence: PA SW127489) | |
| Enumeration Date | 2012-12-13 |
| Last Update Date | 2012-12-13 |