| NPI | 1235790643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: MA 128678) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 22943) |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 1899AD) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: MA 128678) | |
| Enumeration Date | 2019-06-26 |
| Last Update Date | 2025-02-17 |