| NPI | 1760746820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: VA 0904008892) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: IL 29997) |
| 104100000X Social Worker (Licence: IL 150.013327) | |
| Enumeration Date | 2012-07-03 |
| Last Update Date | 2016-01-26 |