| NPI | 1932519089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MT BBH-LCSW-LIC-30553) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MT BBH-LAC-LIC-3377) |
| Enumeration Date | 2014-04-29 |
| Last Update Date | 2019-02-25 |