| NPI | 1962870360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: WI 1843-226) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 16957-130) |
| 104100000X Social Worker (Licence: WI 10714-120) | |
| Enumeration Date | 2015-09-02 |
| Last Update Date | 2015-09-02 |