NPI | 1093300758 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: CO CSW.09929428) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: CO ACD..0002399) |
Enumeration Date | 2021-03-04 |
Last Update Date | 2024-03-01 |