| NPI | 1134672975 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: WI 8967) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: WI 18096) |
| 104100000X Social Worker (Licence: WI 130020-121) | |
| Enumeration Date | 2016-07-28 |
| Last Update Date | 2022-02-01 |