| NPI | 1972523561 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VA 0904003705) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 732) |
| 1041C0700X Social Worker, Clinical (Licence: NC C002940) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2012-08-30 |