| NPI | 1962549733 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: 155) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: TN 1360) |
| 1041C0700X Social Worker Clinical (Licence: TN CMSW0006120) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2021-02-19 |