| NPI | 1972979227 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 16226-132) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: WI 8736-123) |
| Enumeration Date | 2015-08-20 |
| Last Update Date | 2019-01-08 |