NPI | 1245810779 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: KY 259598) |
Additional Taxonomies | 172V00000X Community Health Worker |
101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: KY 278592) | |
Enumeration Date | 2021-04-09 |
Last Update Date | 2024-09-06 |