| NPI | 1083017099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KS 05654) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KS 8527) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 150) | |
| Enumeration Date | 2014-10-04 |
| Last Update Date | 2023-09-27 |