| NPI | 1861743809 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 11473) |
| Additional Taxonomies | 104100000X Social Worker (Licence: TN 8666) |
| Enumeration Date | 2012-10-01 |
| Last Update Date | 2012-10-01 |