NPI | 1114064250 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ME LC4133) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: AZ LISAC-11821) |
1041C0700X Social Worker, Clinical (Licence: AZ LCSW-11136) | |
Enumeration Date | 2007-01-30 |
Last Update Date | 2025-09-11 |