| NPI | 1215300587 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: LA 11703) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: LA 1500) |
| Enumeration Date | 2015-11-09 |
| Last Update Date | 2023-04-05 |