NPI | 1164826301 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 123535) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 15622) |
Enumeration Date | 2014-10-17 |
Last Update Date | 2022-12-21 |