NPI | 1124560834 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: GA CSW007286) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA MSW005748) |
101YM0800X Counselor, Mental Health (Licence: GA MSW005748) | |
Enumeration Date | 2016-11-11 |
Last Update Date | 2022-06-28 |