| NPI | 1912226424 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CT 1100) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| Enumeration Date | 2010-05-24 |
| Last Update Date | 2021-11-18 |