| NPI | 1104186543 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NC C009073) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-23614) |
| 1041C0700X Social Worker, Clinical (Licence: OH S.1000706) | |
| Enumeration Date | 2012-05-18 |
| Last Update Date | 2023-04-13 |