| NPI | 1174641450 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: ID LCSW 1100)  | 
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: ID LCSW 1100)  | 
| 101Y00000X Counselor (Licence: ID LCSW 1100)  | |
| 101YM0800X Counselor, Mental Health (Licence: ID LCSW 1100)  | |
| Enumeration Date | 2007-03-26 | 
| Last Update Date | 2024-09-12 |