| NPI | 1174952956 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KS 06752) |
| Additional Taxonomies | 104100000X Social Worker (Licence: KS 10422) |
| 104100000X Social Worker (Licence: OK 8409) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KS LAC 1124) | |
| Enumeration Date | 2013-11-02 |
| Last Update Date | 2026-02-05 |