NPI | 1023353067 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC16962) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 11769) |
1041C0700X Social Worker, Clinical (Licence: TX 53448) | |
Enumeration Date | 2012-12-03 |
Last Update Date | 2022-11-25 |