| NPI | 1770862872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NE 1561) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE 946) |
| 101YM0800X Counselor, Mental Health (Licence: NE 1317) | |
| Enumeration Date | 2011-08-08 |
| Last Update Date | 2015-04-21 |