NPI | 1053761882 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C011695) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-22344) |
1041C0700X Social Worker, Clinical (Licence: NC P010549) | |
Enumeration Date | 2016-06-13 |
Last Update Date | 2019-02-06 |