| NPI | 1710225602 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: SC 1107274) |
| Additional Taxonomies | 104100000X Social Worker (Licence: 1818) |
| Enumeration Date | 2013-01-28 |
| Last Update Date | 2013-01-28 |