| NPI | 1871514976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 13820) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 8735-120) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2007-11-30 |