| NPI | 1699096941 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI 6801098474) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 104100000X Social Worker (Licence: MA 217377) | |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2015-09-09 |