| NPI | 1720171671 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 2312) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: WI 267-123) |
| 1041C0700X Social Worker, Clinical (Licence: WI 2676-123) | |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2007-07-08 |