NPI | 1811089774 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MT 454LCSW) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT 684LAC) |
Enumeration Date | 2006-09-29 |
Last Update Date | 2008-09-25 |