| NPI | 1881717254 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CT 07422) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 908) |
| 1041C0700X Social Worker, Clinical (Licence: MA 1020242) | |
| Enumeration Date | 2007-04-09 |
| Last Update Date | 2010-10-22 |