| NPI | 1063135473 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 272878) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: IN 87001717a) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 272878) | |
| 1041C0700X Social Worker, Clinical (Licence: KY 257332) | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: KY 272878) | |
| 324500000X Substance Abuse Rehabilitation Facility (Licence: KY 272878) | |
| Enumeration Date | 2022-09-21 |
| Last Update Date | 2024-04-15 |