| NPI | 1003464736 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: OR A17888) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| 101YM0800X Counselor, Mental Health | |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2026-04-20 |