NPI | 1871632729 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NC C003525LCSW) |
Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC 648LCAS) |
Enumeration Date | 2007-02-06 |
Last Update Date | 2009-01-16 |