| NPI | 1760512636 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2013004580) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KS 4780) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 1498) | |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2017-02-17 |