| NPI | 1013647155 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2022-06-13 |
| Last Update Date | 2023-05-10 |