NPI | 1023692548 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL SW18236) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL SW18236) |
101YM0800X Counselor, Mental Health (Licence: FL SW18236) | |
Enumeration Date | 2021-05-11 |
Last Update Date | 2021-05-11 |