| NPI | 1871979922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MT SWP-LCSW-LIC-4449) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT LAC-LAC-LIC-1424) |
| Enumeration Date | 2015-07-30 |
| Last Update Date | 2015-07-30 |