| NPI | 1972053973 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NC P010570) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC LCAS-22936) |
| Enumeration Date | 2016-10-13 |
| Last Update Date | 2016-10-13 |