| NPI | 1063668036 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MD 22317) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VA 0710102573) |
| 1041C0700X Social Worker, Clinical (Licence: VA 0904006914) | |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2025-03-25 |