| NPI | 1851456362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 1205) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 5554-120) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2007-07-27 |