| NPI | 1134571292 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KS 05271) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS 275) |
| 104100000X Social Worker (Licence: KS 10035) | |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2022-05-27 |