| NPI | 1194182337 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT LAC-LAC-TMP-4235) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MT BBH-LAC-LIC-18507) |
| 1041C0700X Social Worker, Clinical (Licence: MT BBH-LCSW-LIC-48148) | |
| Enumeration Date | 2016-01-19 |
| Last Update Date | 2021-01-29 |