NPI | 1093018145 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MI 6801090829) |
Additional Taxonomies | 104100000X Social Worker (Licence: MI 6801090829) |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MI C-03118) | |
Enumeration Date | 2010-12-13 |
Last Update Date | 2016-12-19 |