| NPI | 1760776587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: TX 54304) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT 987) |
| Enumeration Date | 2011-06-09 |
| Last Update Date | 2011-06-09 |