| NPI | 1821143181 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: AZ LISAC-10749) |
| Additional Taxonomies | 104100000X Social Worker (Licence: AZ LCSW-11013) |
| 1041C0700X Social Worker Clinical (Licence: AZ LCSW-11013) | |
| 1041S0200X Social Worker School (Licence: AZ LCSW-11013) | |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2007-07-08 |