| NPI | 1134652019 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-23018) |
| 1041C0700X Social Worker, Clinical (Licence: NC P010814) | |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2022-06-01 |