| NPI | 1982039087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 3192-123) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 1733-132) |
| 101YP2500X Counselor Professional (Licence: WI 1147-125) | |
| 106H00000X Marriage & Family Therapist (Licence: WI 331-124) | |
| Enumeration Date | 2013-09-08 |
| Last Update Date | 2013-09-11 |