| NPI | 1255797205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: LA 11426) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: LA 5117) |
| Enumeration Date | 2016-01-06 |
| Last Update Date | 2022-08-19 |