| NPI | 1144902230 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MT BBH-LCSW-LIC-70243) |
| Additional Taxonomies | 1041C0700X Social Worker Clinical |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| Enumeration Date | 2023-08-07 |
| Last Update Date | 2024-03-22 |