| NPI | 1861726358 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: PA CWO14316) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: PA 5339) |
| 101YM0800X Counselor Mental Health (Licence: PA CW014316) | |
| Enumeration Date | 2009-09-30 |
| Last Update Date | 2013-06-26 |