| NPI | 1093596751 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA LICSW1141431) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical (Licence: MA 229960) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA LICSW1141431) | |
| 101YM0800X Counselor, Mental Health (Licence: MA LICSW1141431) | |
| Enumeration Date | 2023-10-09 |
| Last Update Date | 2026-03-25 |