NPI | 1003803800 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: KS LSCSW3999) |
Additional Taxonomies | 1041C0700X Social Worker Clinical (Licence: MO 2004030209) |
101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: KS LCAC516) | |
Enumeration Date | 2005-10-05 |
Last Update Date | 2025-07-20 |