| NPI | 1013488022 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 11069) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 18605-130) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 16597) | |
| Enumeration Date | 2018-12-17 |
| Last Update Date | 2023-01-11 |