| NPI | 1770951402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR A4300) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: OR 17-08-11) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 2014-000110) | |
| 101YM0800X Counselor, Mental Health | |
| 1041C0700X Social Worker, Clinical (Licence: NJ 44SL06094000) | |
| Enumeration Date | 2015-09-11 |
| Last Update Date | 2019-08-16 |