NPI | 1225634108 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: VT 089.0134722) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: VT 151.0134101) |
Enumeration Date | 2020-12-07 |
Last Update Date | 2023-09-21 |