| NPI | 1902108277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: HI 3686) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: HI 1312-06) |
| Enumeration Date | 2010-11-18 |
| Last Update Date | 2010-11-18 |