| NPI | 1902912272 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ND 1358)  | 
| Additional Taxonomies | 104100000X Social Worker (Licence: ND 2163)  | 
| Enumeration Date | 2006-08-21 | 
| Last Update Date | 2017-11-16 |