| NPI | 1104436880 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: FL SW22864) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: FL ADC-008512-2015) |
| Enumeration Date | 2020-08-06 |
| Last Update Date | 2024-04-03 |