| NPI | 1073865531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MO 2017000895) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 1262) |
| 1041C0700X Social Worker, Clinical (Licence: KS 4575) | |
| Enumeration Date | 2012-10-09 |
| Last Update Date | 2021-03-01 |