| NPI | 1972605103 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: IN 34004998A) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 87000135A) |
| 1041C0700X Social Worker, Clinical (Licence: KY 3822) | |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2016-07-28 |