| NPI | 1700352762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: VT 089.0110736) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: VT 151.0134039) |
| Enumeration Date | 2018-10-17 |
| Last Update Date | 2018-10-17 |