| NPI | 1841483377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: KS LSCSW 1575) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MO MO 2010033353) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: KS LCAC 133) | |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2012-04-03 |