| NPI | 1164192308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: UT 12480515-6009) |
| 104100000X Social Worker | |
| Enumeration Date | 2021-09-19 |
| Last Update Date | 2021-10-18 |