| NPI | 1962794164 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: UT 6242266-3501) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: UT 6242266-6006) |
| Enumeration Date | 2011-05-05 |
| Last Update Date | 2014-02-28 |