NPI | 1093268146 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C012196) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-22699) |
1041C0700X Social Worker, Clinical (Licence: VA 0904012942) | |
Enumeration Date | 2016-07-25 |
Last Update Date | 2024-07-07 |