| NPI | 1972833077 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: CT 008283) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: NY 080136) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: CT 001029) | |
| Enumeration Date | 2010-01-12 |
| Last Update Date | 2013-12-17 |