| NPI | 1093646929 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor (Licence: MA LCSW230453) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 15700) |
| Enumeration Date | 2026-05-28 |
| Last Update Date | 2026-05-28 |