| NPI | 1205272432 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: MA LICSW127790) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 104100000X Social Worker (Licence: NY 119179) | |
| 104100000X Social Worker (Licence: MA 227393) | |
| Enumeration Date | 2013-05-15 |
| Last Update Date | 2024-04-01 |