| NPI | 1043690530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MA 123094) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NH 1071) |
| 1041C0700X Social Worker Clinical (Licence: NH 2125) | |
| Enumeration Date | 2015-06-01 |
| Last Update Date | 2021-01-22 |