| NPI | 1861509291 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: LA 8319) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: LA 845) |
| Enumeration Date | 2006-08-23 |
| Last Update Date | 2012-02-14 |