| NPI | 1134695091 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 104100000X Social Worker (Licence: ID LSW41996) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MT BBH-LAC-LIC-32707) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: MT 32707) | |
| 1041C0700X Social Worker Clinical (Licence: ID LCSW-41996) | |
| Enumeration Date | 2018-10-18 |
| Last Update Date | 2022-04-07 |