| NPI | 1770961906 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ID 10247) |
| Additional Taxonomies | 104100000X Social Worker (Licence: ID LSW-2717) |
| Enumeration Date | 2015-05-07 |
| Last Update Date | 2015-05-07 |