| NPI | 1134833080 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 18722) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 1742AD) |
| 104100000X Social Worker (Licence: MA LCSW229680) | |
| Enumeration Date | 2023-01-05 |
| Last Update Date | 2023-08-26 |