| NPI | 1679826168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 8838-123) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16289-132) |
| Enumeration Date | 2012-10-21 |
| Last Update Date | 2019-07-03 |