| NPI | 1073088662 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MI 6801109977) |
| Enumeration Date | 2018-10-10 |
| Last Update Date | 2021-06-21 |