| 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 |