| NPI | 1215113162 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: NC C008895) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC CCS-20157) |
| 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: NC LCAS 3167) | |
| Enumeration Date | 2008-01-10 |
| Last Update Date | 2022-07-13 |