NPI | 1255630976 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: FL Sw 5629) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: FL CAC115) |
Enumeration Date | 2011-03-21 |
Last Update Date | 2016-12-22 |