| NPI | 1023760543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 9335-123) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 18167-130) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| Enumeration Date | 2022-01-25 |
| Last Update Date | 2022-02-25 |