| NPI | 1972049138 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 104100000X Social Worker (Licence: MO 2015015775) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MO 9544) |
| Enumeration Date | 2017-01-12 |
| Last Update Date | 2017-01-12 |