| NPI | 1013478312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 12001) |
| Additional Taxonomies | 104100000X Social Worker (Licence: WI 132328-121) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 18477) | |
| Enumeration Date | 2019-03-28 |
| Last Update Date | 2025-01-21 |