| NPI | 1700116258 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MT 17638) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MT 1279) |
| Enumeration Date | 2010-01-06 |
| Last Update Date | 2016-05-31 |