| NPI | 1871585919 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NE MSW 1080) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NE LADC 549) |
| 101YM0800X Counselor, Mental Health (Licence: NE LMHP 2614) | |
| Enumeration Date | 2005-08-16 |
| Last Update Date | 2013-09-18 |