| NPI | 1780703108 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CT 03318588) | 
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: CT 03318593) | 
| Enumeration Date | 2007-03-28 | 
| Last Update Date | 2025-09-11 |