| NPI | 1063942076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: TX 109967) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: TX 1977R0423) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC 22926) | |
| 101YM0800X Counselor, Mental Health (Licence: OH I.2304655) | |
| 101YM0800X Counselor, Mental Health (Licence: TX 109967) | |
| 1041C0700X Social Worker, Clinical (Licence: NC P011080) | |
| Enumeration Date | 2017-06-13 |
| Last Update Date | 2025-01-24 |