| NPI | 1235107129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: WI 2593) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: WI 2593) |
| 101YM0800X Counselor, Mental Health (Licence: WI 645-125) | |
| 101YP2500X Counselor, Professional (Licence: WI 645) | |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2020-12-04 |