| NPI | 1972742690 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 1619) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: NC P010401) |
| Enumeration Date | 2009-02-19 |
| Last Update Date | 2017-11-28 |