| NPI | 1780752949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: AZ LCSW-11126) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC-10865) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ ICADC 18225) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ ABCAC 1870) | |
| 101YP2500X Counselor, Professional (Licence: AZ SAP) | |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2013-11-14 |