| NPI | 1154613354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: NC LCAS-22298) |
| 1041C0700X Social Worker, Clinical (Licence: NC P015906) | |
| Enumeration Date | 2011-05-05 |
| Last Update Date | 2024-03-28 |