| NPI | 1770741407 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: ID LMSW-28500) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: ID 1042003) |
| Enumeration Date | 2008-05-29 |
| Last Update Date | 2008-05-29 |