| NPI | 1962957092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NJ 37LC00225000) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NJ 44SL05807400) |
| Enumeration Date | 2016-08-18 |
| Last Update Date | 2016-08-18 |