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 |