| NPI | 1699029991 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: OR L5856) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: OR 04-11-71U3) |
| Enumeration Date | 2012-11-08 |
| Last Update Date | 2013-07-12 |